Background
Optimal care pathways describe the standard of care that should be available to all cancer patients. The Optimal Care Pathway (OCP) for adolescent and young adults (AYA) with cancer outlines steps and standards relating to treatment planning, cancer care, supportive care assessment, referrals, and communication with the general practitioner (GP). The OCP responds to the unique needs of AYAs with cancer and the potential consequences including impacts on mental health, relationships, education, employment, and independence.
This study aimed to assess variation in treatment planning, supportive care, referral to an AYA-specific service, and communication with the GP against the OCP and Victorian targets for AYAs with cancer.
Methods
In 2024, an audit of AYA cancer patient electronic medical records (EMR) across the North Eastern Melbourne Integrated Cancer Service (NEMICS) was conducted. AYA cancer patients (aged 15-25 years) with their first cancer admission at a NEMICS health service during 2021-2023 were identified within the Victorian Admitted Episode Dataset. The patient EMR was used to access evidence of data and information compared to the OCP and targets. Cross-referencing with the Victorian AYA Cancer Service assisted with referral data validation.
Findings
Of 110 AYA patients, 42% were first admitted to Austin Health, 32% Northern Health, 22% Eastern Health, and 4% Mercy Hospital for Women. The most common cancer types were lymphoma, thyroid, genito-urinary, and gynaecological. 74% (target 85%) had MDM presentation for treatment planning. 25% (target 80%) had supportive care screening. 8% had a referral to the Victorian AYA Cancer Service and the service reported evidence of an additional 8 referrals. 3% (target 100%) had communication to the GP.
Conclusion
There is unwarranted variation in AYA cancer care compared to the OCP and Victorian targets, across the network. Improvement initiatives should be co-designed with consumers, clinicians, and services to achieve optimal care.